Introduction: Gout is one of the most common inflammatory arthritis in Malaysia. It is due to persistent hyperuricemia that leads to the formation and deposition of intra- and periarticular monosodium urate crystals either due to excessive production or insufficient excretion of uric acid. Incidence and prevalence of gout is increasing worldwide, with a higher rate among men compared to women. Malay is the largest ethnic group in Malaysia, followed by Chinese and Indian. SLC2A9 is a renal urate transporter that controls renal uric acid excretion and genetic variants in SLC2A9 are associated with the risk of gout in several populations. This study aimed to test if the SLC2A9 variant (R265H, rs3733591) is also associated with gout among Malays in Malaysia. Methodology: A total of 89 patients with gouty arthritis and 100 normal subjects who consented and were recruited in this study. The serum urate and creatinine were measured. The SNP genotyping was performed using PCR-RFLP method for rs3733591 and BST 1236 was used as a restriction enzyme to cut the targeted amplicons. Result: SLC2A9 variant was associated with gout, p-value of 0.007, OR=4.713 [95%CI 1.530-14.513], however this association was not significant after adjustment for age and gender with p=0.465 (OR=1.950; 95%CI[0.325-11.718]). Conclusion: Our data suggest that the genetic variant of SLC2A9 may contribute to the susceptibility of gout among Malays in Malaysia.

Objective To investigate the role of color Doppler ultrasound in the middle and late fetal heart malformations screening and inspection methods.Methods The analysis of 38 cases of fetal malformation of the heart in our hospital from January 2010 to December 2012 and observe a variety of cardiac malformations in different facets of ultrasound performance.Results 38 cases of fetal congenital heart disease were diagnosed by color Doppler ultrasound,which included tetralogy of Fallot in 7 cases (18.42％),6 cases (15.79％) of atrioventricular septal defect,4 cases(10.53％) of single atrium single ventricle,right ventricular dysplasia 3 cases(7.89％),4 cases(10.53％)of left ventricular hypoplasia and 4 cases(10.53％) of partial endocardial cushion defect,3 cases(7.89％) of complete endocardial cushion defect,3 cases (7.89％) of the great arteries transposition,1 (2.63 ％) of pure pulmonary stenosis,2 cases(5.26％) of persistent truncus arteriosus and dextrocardia one cases(2.63％).The pregnant women with high-risk factors were 25 cases(65.79％).20 cases(52.63％) were diagnosed by single four-chamber detection,FCV + (AR-SAV) detected 24 cases(63.16％),higher than the FCV section diagnosis rate(x2 =34.61,P ＜0.05);FCV + VOTV,FCV and + 3VV and FCV + 3VVT section diagnosis rates were 30 (78.95％),37 (97.37％)and 37 (97.37％) respectively,which were significantly higher than FCV section (x2 =35.06,37.22,38.14,P ＜0.05).FCV + 3VV and FCV + 3VVT were significantly higher than the other three facets(x2 =33.97,38.10,34.24,39.02,33.89,35.63,P ＜ 0.05).Conclusion It is important for screening fetal congenital heart disease by Color Doppler ultrasound.The different ultrasonic slice can improve the diagnosis of late fetal heart malformations.

AIM: To determine the effects of anisodamine (Ani) administered intraperitoneally on the gastric mucosal lesion induced by reserpine.METHODS:In reserpine-treated rats, gastric mucosal lesion, gastric acid secretion, gastric barrier mucus secretion, gastric contraction, gastric mucosal blood flow (GMBF), gastric mucosal nitric oxide synthase (NOS) activity and nitric oxide (NO) content were examined.RESULTS:Ani in doses of 1,5 and 10 mg/kg significantly inhibited the formation of gastric lesions induced by reserpine, with the suppressive rate of 60.0%, 66.7% and 76.6%, respectively. Ani (10 mg/kg) significantly inhibited the secretion of gastric acid, but had no effect on the volume of gastric juice. Ani (10 mg/kg) significantly prompted the secretion of gastric barrier mucus. Our findings also showed that Ani (10 mg/kg) significantly suppressed the frequency and amplitude of gastric contraction. Ani (10 mg/kg) significantly prompted GMBF. In reserpine treated rats, gastric mucosal NOS activity and NO content were decreased and Ani (10 mg/kg) could inhibit the decrease in NOS activity and NO content.CONCLUSIONS:The protective effect of Ani may results in part from inhibiting gastric acid secretion, prompting gastric barrier mucus secretion, suppressing gastric contraction and improving GMBF. NO seems to play an important mediator role in the Ani protective mechanisms.

Objective To observe the intrapartum analgesic effect of Doula GT-4a pulse acting working station and the influence of it on labor and mother-to-child. Methods The observation group use intrapartum analgesia of 98 primigravida,and the control group was other 98 primigravida without intrapartum analgesia in the same delivery period. Two groups of gravidas were delivering by a high qualification of midwife while your cervix expand for 2 ～3cm. The observation group was given with GT-4a pulse acting working station. Results The analgesia VAS scores of the observation group,significantly different with that of the control group:The first stage of labor active period accelerated significantly,the second stage of labor was shortened. The cesarean section rate,the vaginal birth rate and the neonatal mild choking rate significantly declined compared with the control group. Though there were no statistical differences between two groups with the third stage of labor, postpartum hemorrhage, and neonatal severe choking rate.Conclusion The andlgesie effect of doula combined with GT-4 pulse theraphy for labor was good. It reduced cesarean section rate, improved maternity quality and had no adverse effects.

Medical students participating in chnieal medical early is one of the good ways to cultivate students'all-around qualities From freshman year medical students begin to enter chnical medical service system and make clinical practice in spare time,They are also trained to link theory with practice to caltivate clinical thinking ability,strengthen its humanistic care idea and doctor-patient communication ability so that medical students will know the sacred profession of being adatov and from the idea of sewing patients work of the sacred doctor,set up'professional service to patients'concept.

To investigate the effects of comprehensive and integrated therapy on the recovery of facial nerve function,60 patients with post-stroke facial nerve injury were divided into two groups:Group A (control group) was administered a simple conventional medication,and Group B underwent acupuncture by total considered therapy and was administered a simple conventional medication.Thirty patients were enrolled in each group.The Portmann modified clinical symptom score,intracranial hemodynamics,and electrophysiological parameters were analyzed before and after treatment.Thirty days later,the clinical symptom score in Group B increased significantly compared with that in the control group ( Group B,17.0 ±2.5 ; Group A,13.0 ±2.0; P ＜0.01 ).Group B showed significant improvements in middle cerebral artery blood flow [ Group B,(90 ± 17 ) cm/s; Group A,( 52 ± 15 ) cm/s ; P ＜ 0.01 ],facial nerve conductivity [Group B,latency of the ipsilateral orbicularis muscle,(3.35 ± 0.67) ms; Group A (3.95 ±0.58) ms;P ＜ 0.01 ].These results indicate that the total considered therapy improved the recovery of post-stroke facial nerve function and that this improvement was related to the increase in intracranial blood supply.

Digestive endoscopic diagnosis and treatment technology in the development of ethical issues are :the expansion of endoscopic treatment indications , violation of patient choice;Health care costs increase , the pa-tient cannot enjoy medical equality;Staff is uneven , the patient can′t enjoy the fair medical treatment;Paternalistic doctor-patient relationship , ignore the patient′s autonomy and so on .Puts forward some Suggestions to solve these problems:people-oriented , fully respect patients option;Standard medical behavior , advocates the equal medical treatment;Standardized training for everyone to enjoy fair medical treatment;Build the good doctor -patient rela-tionship , respect the autonomy of patients .

BACKGROUND:Surgical treatment is mostly adopted in the treatment of III-IV pelvic organ prolapse, in which, the appropriate patch can be used to implement the pelvic floor reconstruction so as to reconstruct the pelvic anatomic relationship and restore the normal pelvic organ function. OBJECTIVE: To verify the efficacy and biocompatibility of the non-absorbable mesh reconstruction of the pelvic floor in III-IV pelvic organ prolapse. METHODS: Totaly 127 female cases of III-IV pelvic organ prolapse were enroled, aged 31-81 years. Of the 127 cases, 65 cases undergoing vaginal hysterectomy and anterior and posterior vaginal wal repair served as control group, another 62 cases undergoing pelvic floor reconstruction using non-absorbable mesh acted as observation group. The two groups were observed in the perioperative period and then folowed up for 12 months. POP-Q measurement, pelvic floor function and adverse reactions were observed in the two groups. RESULTS AND CONCLUSION:The operation time and blood loss in the observation group were less than those in the control group (P < 0.05). After 12 months of folow-up, the results of POP-Q measurement were significantly improved in the both groups compared with the previous (P< 0.05), but there was no difference between the two groups. In addition, pelvic floor static tension, dynamic tension and contraction force were stronger in the observation group than the control group (P < 0.05). In the observation group, there were six cases of mesh corrosion, one case of infection and one case of dysuria. It is indicated that the non-absorbable mesh reconstruction of the pelvic floor can effectively restore the pelvic energy in patients with III-IV pelvic organ prolapse, but there are some adverse reactions such as mesh corrosion.

ObjectiveTo observe the effect of pus-draining and bloodletting with sharp-hook needle in repairing the skin lesions in acne vulgaris of nodules type.MethodTwenty pairs of skin lesions caused by acne vulgaris of nodules type were divided into a treatment group and a control group. The treatment group was intervened by pus-draining and bloodletting with sharp-hook needle, while the control group was by pus-draining with sharp-hook needle. Two facial skin lesions of same size were selected from each patient to respectively receive pus-draining and bloodletting with sharp-hook needle or pus-drainage alone. The changes of lesion size and hardness in a week were observed and compared.ResultThe reducing of lesion size was more significant in the treatment group than that in the control group (P<0.05), and the improvement of hardness of the lesions in the treatment group was also more significant in the treatment group than that in the control group (P<0.05).ConclusionPus-draining and bloodletting with sharp-hook needle can produce amore significant effect in repairing skin lesions in acne vulgaris than pus-draining alone.